Prognostic role of the lymph node ratio in node positive colorectal cancer: a meta-analysis

The lymph node ratio (LNR) (i.e. the number of metastatic lymph nodes divided by the number of totally resected lymph nodes) has recently emerged as an important prognostic factor in colorectal cancer (CRC). However, the tumor node metastasis (TNM) staging system for colorectal cancer does not consi...

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Bibliographic Details
Published in:Oncotarget 2016-11, Vol.7 (45), p.72898-72907
Main Authors: Zhang, Ming-Ran, Xie, Tian-Hang, Chi, Jun-Lin, Li, Yuan, Yang, Lie, Yu, Yong-Yang, Sun, Xiao-Feng, Zhou, Zong-Guang
Format: Article
Language:English
Subjects:
Aged
Colorectal Neoplasms - mortality
Colorectal Neoplasms - pathology
Humans
Lymph Nodes - pathology
Lymphatic Metastasis
Middle Aged
Neoplasm Staging
Prognosis
Publication Bias
Research Paper
Survival Analysis
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Summary:The lymph node ratio (LNR) (i.e. the number of metastatic lymph nodes divided by the number of totally resected lymph nodes) has recently emerged as an important prognostic factor in colorectal cancer (CRC). However, the tumor node metastasis (TNM) staging system for colorectal cancer does not consider it as a prognostic parameter. Therefore, we conducted a meta-analysis to evaluate the prognostic role of the LNR in node positive CRC. A systematic search was performed in PubMed, Embase and the Cochrane Library for relevant studies up to November 2015. As a result, a total of 75,838 node positive patients in 33 studies were included in this meta-analysis. Higher LNR was significantly associated with shorter overall survival (OS) (HR = 1.91; 95% CI 1.71-2.14; P = 0.0000) and disease free survival (DFS) (HR = 2.75; 95% CI: 2.14-3.53; P = 0.0000). Subgroup analysis showed similar results. Based on these results, LNR was an independent predictor of survival in colorectal cancer patients and should be considered as a parameter in future oncologic staging systems.
ISSN:1949-2553
1949-2553
DOI:10.18632/oncotarget.12131